Is it a priority? I can't answer that. Where the needs of patients' families determine they should be members of the team, there should be more opportunity than what we have. But we also need to use the opportunities we have to do more prevention.
All members of the team working to full scope and focusing on what they ought to be focusing on perhaps is an example. If you look at depression among women of childbearing age, in one of the family practices in which I was doing some work it tended to be the number-one billable code in that age group. When we introduced nurses into the family practice, we really started focusing on the importance of having them assess the extent to which the depression was interfering with parenting in women who were depressed. It can put children at risk of neglect, abuse, and so on if the depression is severe enough.
It's a way of beginning to look at the many opportunities to introduce primary prevention. The woman's depression needs to be treated, but the children's well-being also needs to be attended to. So you begin to look at more than one member of the health care team working in a particular context, and shift your focus away from just managing the disease--depression--to look at the issues that surround the needs of that patient's family. Then there are more opportunities to look at all the other health care providers who could become part of the care team and manage people far better, so we don't have people constantly on the treadmill of treatment, illness, and so on.